Introduction Normal glucose levels are important not only for energy but for many other functions including adequate nerve conduction. 1 The disease process of diabetes causes alterations in the normal nerve functions which can be reflected either when performing neurological examination or during electrophysiological testing of the patient. The neurological scores and the electrophysiological studies both are used for the diagnosis of the sensorimotor neuropathy. The relations between physiology and pathophysiology emphasize the close interdependence between electrophysiological studies and clinical findings. 2 The neuropathies are among the most common of the long-term complications of diabetes, affecting up to 50% of patients in the world. 3 The prevalence of neuropathy in type 2 diabetics is about 40% in some areas of Pakistan and it is likely to increase more than twice between years 2000- 2030. 4,5 Pakistan is among the countries where ratio of previously undiagnosed to known diabetes is 2:1. 6 The electrodiagnostic evaluation of diabetic polyneuropathy has been done in our set up but still there is a need to formulate a standard protocol for diagnosing the disease at early stage. In recent years different protocols have been developed to establish minimum criteria for the detection 166 J Pak Med Assoc Original Article Reliability of the neurological scores for assessment of sensorimotor neuropathy in type 2 diabetics Ambreen Asad, 1 Muhammad Amjad Hameed, 2 Umar Ali Khan, 3 Nadeem Ahmed, 4 Mujeeb-ur-Rahman Abid Butt 5 Army Medical College/NUST, 1 Islamic International Medical College, 2,3 Armed Forces Institute of Rehabilitation Medicine, 4 Combined Military Hospital, 5 Rawalpindi, Pakistan. Abstract Objective: To check the reliability of the commonly used neurological scoring systems taking the nerve conduction studies as the reference. Methods: Diagnosed diabetics (n=60) were selected by purposive sampling. Detection and grading of neuropathy were done according to Diabetic Neuropathy Symptom Score (DNS), modified Neuropathy Symptom Score (NSS), Diabetic Neuropathy Examination (DNE) and modified Neuropathy Disability Score (NDS). For the nerve conduction studies, amplitudes, velocities and latencies of minimum two (Sural, Peroneal) and maximum six i.e. three sensory (Sural, Ulnar, Median) and three motor (Peroneal, Ulnar, Tibial) nerves were checked. If the patient had 2 or more than two abnormal findings in any of the nerve he was labeled to have peripheral sensorimotor neuropathy. Later the sensitivity, specificity and diagnostic efficacy of each neurological score was checked taking nerve conduction studies as the gold standard. Results: Taking the NCS as gold standard DNS, DNE, NSS and NDS had 64.1%, 17.95%, 82.05%, 92.31% sensitivity and 80.95%, 100%, 66.67%, 47.62% specificity, respectively. Diagnostic efficacy of DNS was 70%, DNE was 47%, NSS was 77% and NDS was 77%. Conclusions: Combining different scores gives better sensitivity and specificity. NDS is the most reliable neurological test for detecting and grading DPN (JPMA 60:166; 2010).